Effect of early burn wound cooling with tap water and hydrogel on clinical outcomes in scald injuries.

OBJECTIVE

This study aimed to assess the effects of first aid methods, including early burn wound cooling with running tap water and/or Burnshield® hydrogel, versus no treatment or inappropriate first aid on clinical outcomes in patients with scald burns.

METHODS

In this single-center retrospective analysis, we compared cooling first aid (defined as cooling with running tap water and/or hydrogel within 8 h after injury) with inappropriate or no first aid in 2566 patients with scald burns. Outcomes included time to complete epithelialization, surgical debridement, split-thickness skin grafting, systemic antibiotic use, hospitalization, age-stratified effects (pediatric/adult/geriatric), the effect of combining water with hydrogel, and timing of hospital admission.

RESULTS

Overall, 73.4% of patients received cooling first aid. Median healing time was significantly shorter in the cooling first aid group 11 (8-14) days compared with the inappropriate first aid group 16 (12-23) days and the no first aid group 16 (12.25-23) days (p < 0.001). Cooling first aid was also associated with lower rates of debridement (17.05%), grafting (5.20%), systemic antibiotic use (11.84%), and hospitalization (17.26%) compared with inappropriate or no first aid (all p < 0.001). Median healing time differed by age group, with values of 12 (8-15) days in pediatric patients, 12 (8-15) days in adults, and 17 (12-23) days in geriatric patients (p < 0.001). The combination of tap water plus hydrogel yielded the shortest median healing time 10 (7-13) days and the lowest intervention rates. Admission within 24 h was associated with significantly better outcomes than later admission.

CONCLUSIONS

Early cooling first aid substantially improves clinical outcomes in patients with scald burns. These findings support the effectiveness of hydrogel-based cooling as an adjunct to water irrigation and highlight the need for widespread public education on evidence-based first aid practices.